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What is the challenge or opportunity you are focussing on ?

 

It has been identified through hospital data that patients discharge home from our hospital mid to late afternoon any time from 14:00 hours to 18:00 hours. This does not correlate with the admissions presenting to hospital from the Emergency Department which peaks from 11:00 hours up to 15:00 hours and again from 17:00 hours up to 19:00 hours. I would like to carry out a focussed project in moving the discharge time forward for our patients creating visual images and documentation to communicate this with patients, relatives and staff alike, hence my focus on the project – Home by One. I would like to try to ensure all our staff are focussed on the priority of ensuring patients are prepared for discharge and will transfer to the Discharge Lounge as part of their journey through the hospital. I would like relatives to be aware of the time we expect their loved ones to be discharged from hospital so they can make appropriate arrangements to collect them. I would like to understand why staff are reluctant to use the discharge lounge which assists flows from and to the wards.

 

  

Your proposal

 

My proposal is to work with the ward sisters and their staff to rectify the barriers they have identified that prevent them from using the discharge lounge following two meetings with them. I would also like to bring the patients perspective into this work and would include a questionnaire to the patients about how they feel about the discharge lounge, the staff and the facilities provided. I have already met with an expert patient and made some amendments based on her suggestions and feedback, but would like to explore this further. I want to carry out a full communication initiative with patients, relatives and staff with the focus on preparing the patient for discharge earlier in the day, moving the day forward, allowing patients to get home at an earlier hour in the day, which in turn will reduce the delays on patients waiting for beds in the Emergency Department. I would like to create a visual image which would be on display at each ward entrance and at the entrance into hospital and I would in time wish to expand this communication onto platforms such as twitter and facebook as well at the Trusts website.

 

 

Benefits – what I hope to achieve.

 

I would like to ensure everyone is focussed on the timely, safe discharge of our patients from hospital – aim is “Home by One”. Part of the benefit of this is to allow patients to get settled back into their own homes during daylight hours and this is particularly pertinent during the winter months. The benefit of this for the patient waiting to get into a hospital bed from the Emergency Department is that they can do so in a more timely manner and prevent long waits in ED. I would like our discharge lounge to be part of the journey of our patients through the hospital and the facility to be the best it can be and to ensure the discharge from hospital for our patients ends in a friendly, relaxed environment.

 

 

 

Benefits to Q community

 

I would be happy to share the learning from this project, share the pitfalls to avoid if embarking on similar work, and hopefully, to hare the benefits to patients and families of an earlier in the day discharge from hospital. I would also hope that any reduction in delays on patients waiting for beds in the Emergency Department will be evident and could be easily replicated across other organisations.

 

                       

 

How you can contribute

  • I would appreciate advice from Q members who may have undertaken a similar project, and any lessons learned or products that they developed which worked well.

Comments

  1. This would make a difference to your patient flow and free up beds so patients waiting in A&E could get to a ward in a timely manner. Clearly helpful for those getting home at a reasonable time in the day. Culture change is really important on this one, worth the effort. Best of luck.

  2. Hi. I'm sure an effective ward round would help with getting patients home by 1. I have been trying to identify best practice in a 'generic' ward round. Please have a look at http://www.catmalvern.co.uk/nhs/WardRound.html Would more detail on the documentation displayed via this process visualization help 'home by 1'? I can add any detail you suggest. Regards Tom

  3. Hi Gill and team

    Thank you for sharing your project. I thought it might be helpful to share some learning I've got, having worked at Barnet hospital in North London who launched a similar campaign, 'home for lunch'. Often the mindset was about setting discharge goals on admission and having posters and communication about going home expectations; are you planning on tackling any of this from admission? Key to this project was the bed management team who drilled this in to everyone during the bed meetings. The status board also changed to note down how many discharges pre and post lunch; it was healthy competition for different wards. I also wonder how ot/pt will be involved in this because they are also crucial to changing this pathway.

     

    It would be good to understand how you'd evaluate success and you've touched on some ideas in your proposal, eg delays waiting for beds in ED. I'd also be interested in staff perceptions of this initiative and how they see it contributing to patient care and safety (rather than it being just about releasing the bed).

    Finally, I did my masters dissertation on the use of the discharge lounge and have some interesting insights which I'd be happy to share with you! Good luck

    Dimple

    Q Programme Manager

     

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